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. Author manuscript; available in PMC: 2019 Apr 1.
Published in final edited form as: Eur Spine J. 2018 Feb 19;27(4):739–751. doi: 10.1007/s00586-018-5488-1

Table 2.

Definition of Histological Grading Scale

I. Anulus fibrosus:
Grade:

  1. normal, pattern of fibrocartilage lamellae (U-shaped in the posterior aspect and slightly convex in the anterior aspect) without ruptured fibers and without a serpentine appearance anywhere within the anulus

  2. ruptured or serpentined patterned fibers in less than 30% of the anulus

  3. ruptured or serpentined patterned fibers in more than 30% of the anulus

II. Border between the anulus fibrosus and nucleus pulposus:
Grade:

  1. normal

  2. minimally interrupted

  3. moderate/severe interruption

III. Cellularity of the nucleus pulposus:
Grade:

  1. normal cellularity with large vacuoles in the gelatinous structure of the matrix

  2. slight decrease in the number of cells and fewer vacuoles

  3. moderate/severe decrease (>50%) in the number of cells and no vacuoles

IV. Matrix of the nucleus pulposus:
Grade:

  1. normal gelatinous appearance

  2. slight condensation of the extracellular matrix

  3. moderate/severe condensation of the extracellular matrix

Histological grading scale based on four categories of degenerative changes with scores ranging from a normal disc with 4 points (1 point in each category) to a severely degenerated disc with 12 points (3 points in each category).